Health Disparities in Marginalized Population Paper

1. Using Technology for Cardiovascular Health Education and
Health Promotion at Community Health Event
Author: Rajendra J. Jagad B.Sc Co-Author: Dr. Akhil Bansal MD. PhD
raj@healthparameters.com Co-Author: Chirga V. Boghani B.Pharm
Student Participation: Aieshwarya Singh, Daniel Alvarado, Moe Abdo, and Cruz Castalio
Introduction: Health education within the United States and more globally has primarily been seen
through the lens of secondary and tertiary prevention, educating patients about disease which is already
present in order to minimise harm. However, health education and promotion must also incorporate
primary prevention, as a proactive approach to health has been shown to reap the greatest economic
and health benefits for the broader community[1]. Although traditionally it has been thought that it
remains the responsibility of government and public organisations to disseminate primary prevention
health education[2], there are limitations to this. Governments often are limited by their own budgetary
constraints, and often fail to serve marginalised and under-recognised communities, such as people of
colour, migrants and seasonal workers[3]. Specifically, this study sought to educate and improve
awareness of cardiovascular disease and the common arrhythmia atrial fibrillation[4].
Methods: Throughout 2018-2019, a research team in the Eastern Carolina region, supported and
funded by local healthcare students from Eastern Carolina University and local businesses, ran two
events, setting up a booth with an FDA approved, simple single lead electrocardiogram (ECG) from
Alivector Kardia Mobile. They consented all potential participants and offered to perform an ECG on
each of them. It was made clear that such a test was not diagnostic and did not constitute medical
advice. Rather, the purpose was to educate participants about their cardiac health, what a normal and
abnormal cardiac rhythm was, and to show the effects of consuming water on their cardiovascular
health. During testing, participants were informally interviewed on their perception of the event and its
purpose.
Results: Two events were conducted throughout 2018-2019, organised in affiliation with Eastern
Carolina University students, as well as with the financial and logistical support of local businesses.
Over the first event, a total of n = 46 participants came to the health promotion booth. Of these, n = 38
consented and agreed to patriciate in the health education activity. These participants had a range of
cardiac rhythms; most participants had a normal rhythm (63.2%), with 5.3% (n=2) participants
showing a previously unknown atrial fibrillation rhythm. Over the second event, a total of n=13
participants were involved, and participants were encouraged to receive an ECG before and after a
hydration challenge of 8 ounces of plain bottled water. In this study, 7% (n=1) patient displayed an
atypical cardiac rhythm.
From the informal qualitative interviews, participants reported an overwhelmingly positive experience
of this mobile health education event. A vast majority of them were not aware of their current
cardiovascular health status and were eager to take a printed copy of their ECG to their primary health
care physician for further discussion. Further, participants were interested in learning about the

2. importance of maintaining a balanced fluid status in cardiovascular health and were receptive to
learning about the implications of dehydration and overhydration. Participants were clear that this
event was purely for health promotional purposes and were excited to see community-led initiatives
that promoted health. Most of the participants reported that they primarily saw their doctor with a
particular medical issue or concern, and a majority of participants reported that this and similar
initiatives would make them more proactive and seek out information and data about their health
themselves.
Discussion: This study establishes a significant area of demand; independent, community led health
promotion initiatives. We found that participants were significantly interested, but undereducated,
about their cardiovascular health. Participants were receptive to non-diagnostic testing and were
responsive to education about the importance of hydration in maintain their cardiovascular health[5].
They found the clinic useful, and helped them take ownership of their health[6].
Participants are interested in learning about various other aspects of their health, such as respiratory and
musculoskeletal health[7], and are also interested in learning about how they can access and interpret
the data from their smart wearable technology to inform their health[8].
Conclusion: This study established a strong interest and need for health promotional activities in the
community, and with the aid and support of community investment and the involvement of relevant and
interested healthcare students and professionals, it is imperative that such operations are continued and
expanded. Particularly in the time of COVID-19, where the public are increasingly interested in
proactively managing their health, there is no better time than now.
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